Physician trainees’ compassion satisfaction, burnout, and self-efficacy when caring for people who inject drugs

Abstract

Background: Front-line providers working with people who inject drugs (PWID) are at increased risk of experiencing burnout. Few studies have examined protective factors against burnout incurred in the care of PWID, including harm reduction counseling skills. We measured self-efficacy in harm reduction counseling, burnout, and compassion satisfaction among Internal Medicine (IM) trainees caring for PWID. Methods: In this cross-sectional study, we surveyed IM interns and residents. Self-efficacy was assessed by asking trainees about attitudes, comfort, and knowledge in harm reduction counseling on a five-point Likert scale. Burnout and compassion satisfaction were assessed via an adapted 20-question Professional Quality of Life Scale. We compared self-efficacy in harm reduction counseling, compassion satisfaction, and burnout between interns and residents using ANOVA and Mann–Whitney U tests. We used Spearman’s rho correlational analysis to examine the relationship between these three variables. Results: Seventy-nine IM trainees (36 interns, 43 residents) completed the survey for a 52% response rate. Residents reported higher self-efficacy in harm reduction counseling, similar levels of burnout, and higher compassion satisfaction compared to interns. Across training levels, we found a negative correlation between burnout and compassion satisfaction (r = −0.55, p < 0.01) and a positive correlation between compassion satisfaction and comfort counseling PWID on harm reduction (r = 0.30, p < 0.01). Conclusions: Among IM trainees at an urban institution serving a large population of PWID, self-efficacy in harm reduction counseling and compassion satisfaction increase with time in training while burnout remains similar. Strengthening trainees’ capacity to counsel PWID on harm reduction may improve their compassion satisfaction in caring for this population, potentially leading to improved care. This relationship should be explored longitudinally in larger cohorts and through evaluations of harm reduction-focused medical education.

Keywords:

• Harm reduction
• burnout
• compassion satisfaction
• residents
• people who inject drugs

Acknowledgment

Neither NIDA, nor NIAID had a further role in study design, in the collection, analysis and interpretation of data, or in the decision to submit the paper for publication.

Disclosure statement

No potential conflict of interest was reported by the author(s). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of Boston Medical Center of any of its academic affiliates

Author contributions

RJ conceived of the study concept and drafted the manuscript. JL and NS advised on all aspects of the study and contributed to manuscript preparation and revisions. LD conducted statistical analyses and reviewed drafts of the manuscript. GWM advised on all aspects of the study and contributed to manuscript preparation and revisions. All authors approved the final version for publication.

Additional information

Funding

This work was supported by the National Institute on Drug Abuse [R25DA033211 to R.J.], National Institute of Allergy and Infectious Diseases [T32AI052074 to R.J] and an internal Education Pilot Grant at Department of Medicine at Boston University School of Medicine.